Study Can Help with Child Brain Injury Prevention

A study recently reported to the New England Journal of Medicine could be useful in coming up with age-specific strategies to prevent traumatic brain injury (TBI) among children.

Researchers from the Pediatric Emergency Care Applied Research Network (PECARN) reported the study’s results in a “Letter to the Editor” in the November issue of NEJM.

According to the researchers, they examined data involving 43,399 children under age 17 – 98 percent of whom had experienced some form of mild head trauma – who had been seen at any one of 25 emergency rooms between 2004 and 2006. The study placed the children into three age groups: Under age 2, 2-12 and 13-17.

As NPR.org notes, the researchers found that the way children suffer head and brain injuries “evolves as their forms of motion change” as they age.

For instance, the researchers found the following to be the “top three injury mechanisms” in the three different age groups:

AGE 2-UNDER

Injury Mechanism	Total	Frequency
Falls from elevation	5,887	54%
Falls down stairs	1,533	14%
Falls from standing / walking / running	979	9%

AGES 2-12

Injury Mechanism	Total	Frequency
Falls from elevation	5,653	24%
Falls from standing / walking / running	3,189	14%
Object struck head – accidental	2,181	9%

AGES 13-17

Injury Mechanism	Total	Frequency
Assault	2,186	24%
Sports	1,751	19%
Occupant in motor vehicle crash	1,659	18%

The study also identified the most common types of brain injuries that were identified after children went through a CT scan. The three leading types were:

• Subdural hematoma – When blood pools in the tissue layers surrounding the brain (326 visualized on CT scans)
• Subarachnoid hemorrhage – Bleeding in the space between the brain and the tissues covering the brain, or “subarachnoid space” (283)
• Cerebral contusion – A “bruise” on brain tissue (254).

The researchers noted that 556 children had more than one type of TBI that was detected through a CT scan.

NPR points out that the study also revealed how certain safety equipment can reduce the risk of suffering serious brain injuries. For instance:

• When children are in a car accident, they face a 5 percent risk of suffering TBI. However, when they wear a seat belt or sit in a carrier, the risk falls to 2 percent.
• Eight percent of children suffer TBI when hit by a car while biking when they are not wearing a helmet. However, when wearing a helmet, the rate drops to 5 percent.

How Can This Information Be Used to Prevent Child Brain Injuries?

As one of the study’s authors told NPR, the study results can be used to craft brain injury prevention strategies that address specific age groups. For example, in the age 2-under age group, there is a low rate of TBI from car crashes. This may be due to a greater use of infant carriers that has resulted from laws and public awareness campaigns. However, there is a high rate from falls down stairs. Perhaps a public awareness campaign about the need to use “baby gates” in the home could reduce those types of accidents leading to TBI.

Additionally, the study’s results make it clear that more must be done to prevent TBIs, including concussions, among teen athletes and to encourage them to “buckle up” when driving in order to reduce the risk of TBI from a car accident.